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Epilepsy and Seizures

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What's the Problem?

Epilepsy is a general term for more than 20 types of seizures. People diagnosed with epilepsy have had more than one seizure, and they may have more than one kind of seizure. About 2.3 million people in the United States have some form of epilepsy.

A seizure happens when abnormal electrical activity in the brain results in an involuntary change in body movement or function, sensation, awareness, or behavior. It can last from a few seconds to minutes. No one has determined a single cause for the vast majority of epilepsy cases. Head trauma, stroke, brain tumor, poisoning, infection, inherited conditions, or problems during fetal development may cause seizures.

The symptoms depend on the location of electrical activity in the brain; they may be very frightening to onlookers. A person having a tonic-clonic (grand mal) seizure may cry out, lose consciousness and fall to the ground, and have rigidity and muscle jerks. A person having a complex partial seizure may appear confused or dazed and unable to respond to questions or direction. Some people have seizures that are not noticed at all by others. Sometimes, the only clue that a person is having an absence (petit mal) seizure is rapid blinking or staring into space.

People with epilepsy are often stigmatized (feel ashamed or marked by the condition) and suffer legal, social, and employment consequences. They may be unable to get a driver's license if seizures are not controlled by medication. Because of these barriers, 20% to 30% of people who experience seizures but are physically able to work are unemployed. Many who work are underemployed. Those who have seizures only occasionally must decide whether to talk about it or hide it. For many, discussing it can affect their social lives and ability to earn a living.

Who's at Risk?

Epilepsy is one of the most common disabling neurological disorders. Under certain conditions, anyone—young or old—can have a seizure.

Can It Be Prevented?

Current treatment methods can control seizures for approximately 66% of people with epilepsy. Antiepileptic drugs are the most common form of treatment. When medication is not effective, surgery may be. In children and some adults with certain types of seizures, a special high-fat, low-carbohydrate diet may reduce seizures when other treatments don't work.

The Bottom Line

Epilepsy is not a mental illness. People who have seizures have a medical condition that can be treated. It's a myth that someone with epilepsy will swallow his or her tongue. However, if you're around someone having a seizure there are things you can do to help. Loosen clothing, remove objects the person may bump against or hit, and be there when the seizure ends to help the person get up and move to a chair or couch. Be aware and supportive. People who have seizures can benefit from talking to co-workers and friends about their condition.

Case Example

A pet store manager yells at Allen, a 16-year-old part-time employee, because he didn't change the water in a tank of fish when asked. Several expensive fish died as a result. The manager warns that if Allen can't pay attention or daydreams again, he'll be fired. Allen is upset and scared about losing his job. He knows he has epilepsy (absence seizures), but he's afraid he'll be fired if he tells his boss. The seizures are usually controlled by medicine, but occasionally he blanks out and doesn't hear something. The boy agonizes over whether to tell his manager. Two months later, he has another seizure and a lop-eared bunny escapes from a cage and is locked in a storeroom overnight. The manager fires him the next day. With nothing left to lose, Allen tells the manager about his condition. The manager allows Allen to keep his job and agrees to monitor his work a little more closely.